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    SKin Graft

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    Rinna Numberi,MD
    Skin grafting is a procedure where partial or full thickness skin is harvested from a donor site and transferred to a recipient site. Split thickness skin grafts involve harvesting the epidermis and partial dermis, while full thickness skin grafts include the full dermis and can result in less contraction but are limited to small defects. The success of skin grafts relies on adequate blood supply and revascularization at the recipient site. Complications can include poor graft take if the recipient site has insufficient blood flow or becomes infected.

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    SKin Graft

    Uploaded by

    Rinna Numberi,MD
    16 views19 pages
    Skin grafting is a procedure where partial or full thickness skin is harvested from a donor site and transferred to a recipient site. Split thickness skin grafts involve harvesting the epidermis and partial dermis, while full thickness skin grafts include the full dermis and can result in less contraction but are limited to small defects. The success of skin grafts relies on adequate blood supply and revascularization at the recipient site. Complications can include poor graft take if the recipient site has insufficient blood flow or becomes infected.

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    Definition, indication of skin graft

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    Skin grafting is a procedure where partial or full thickness skin is harvested from a donor site and transferred to a recipient site. Split thickness skin grafts involve harvesting the epidermis and partial dermis, while full thickness skin grafts include the full dermis and can result in less contraction but are limited to small defects. The success of skin grafts relies on adequate blood supply and revascularization at the recipient site. Complications can include poor graft take if the recipient site has insufficient blood flow or becomes infected.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    16 views19 pages

    SKin Graft

    Uploaded by

    Rinna Numberi,MD
    Skin grafting is a procedure where partial or full thickness skin is harvested from a donor site and transferred to a recipient site. Split thickness skin grafts involve harvesting the epidermis and partial dermis, while full thickness skin grafts include the full dermis and can result in less contraction but are limited to small defects. The success of skin grafts relies on adequate blood supply and revascularization at the recipient site. Complications can include poor graft take if the recipient site has insufficient blood flow or becomes infected.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 19

    Skin Graft

    Textbook Reading
    Maryam N. Arina
    Microsurgery 1st Rotation

    RS Kanker Dharmais
    Supervisor:
    dr. Dewi Aisiyah Mukarramah, SpBP-RE(K), dr. Irsyad
    M. Kiat, SpBP-RE, dr. Kasih Rhardjo Djarot, SpBP-RE
    Anatomy
    Wound Healing and Reconstructive Ladder
    Skin Graft
     A procedure of skin transplantation by harvesting partial or full thickness of
    the skin from a donor site and transferring it to a recipient site (raw
    surface/recipient/host bed)

     The recipient site should have adequate blood supply to ensure the success
    of skin grafting as the skin grafts fully rely on the recipient site
    vascularization for nourishment and hence survival

     The harvested skin includes epidermis and partial or full thickness of the
    dermis, depending on the requirements
    History
     Baronio (1804) : First successful skin grafting on lambs

     J.L Reverdin (1869) : closure of granulation tissue with a graft containing epidermis and dermis

     G.Lawson (1870) : FTSG sized 1 cm from upper arm to reconstruct eyelid

     J.R.Wolfe (1875) : FTSG sized 2x5x5 cm cm from upper arm to reconstruct eyelid

     K.Thiersch (1874) : the use of shaving knife to harvest skin graft


     Split Thickness Skin Graft (STSG): Epidermis to
    partial thickness of dermis, hairless
     Thin : Epidermis + ¼ layer of dermis
    Classification  Intermediate : Epidermis + ½ layer of dermis
    and Origin
     Thick : Epidermis +3/4 layer of dermis s

     Full Thickness Skin Graft (FTSG): epidermis full


    layer of dermis includes hair
    Classification and Thickness
    Autograft
    Classification
    based on Homograft / Allograft
    Origin
    Heterograft / Xenograft
    1. Serum imbibition/plasmatic circulation (first
    24-48 hours)
    2. Inosculation/ blood vessel connection (3rd day)
    Graft Take
    3. Revascularization (4th day)
    Process
    4. Graft maturation  graft undergoes
    contraction and eventually complete
    maturation in 6 months to 1 year post
    procedure
    If wound closure cannot be achieved primarily, e.g.:

     Inadequate surrounding tissues for wound coverage

    Indications  Post tumor removal wound with unclear tumor-free


    margin

     If other methods pose higher morbidity, risk, or


    complications and if patients’ general condition is unfit
    for closure with skin flap
    Advantages and Disadvantages

    STSG
    Advantages Disadvantages

    Take probability is higher Secondary contraction

    Can be used for for large defects Skin color changes

    Donor regions are many Glossy appearance

    Donor can heal primarily Aesthetically unpleasing


    Advantages and Disadvantages
    FTSG
    Advantages Disadvantages

    Primary contraction Lower take probabiblity

    Minimal skin color changes Only able to close small defects

    Minimal glossy appearance Donor site should be closed primarily

    Aesthetically better than STSG Donor regions are limited


    Technique
    STSG
     Preparations : aim an area for donor site
     Harvesting : Using no.22 scalpel, Humby knife or dermatome
     Determine the thickness required for closure
     Fixation with sutures if needed
     Donor site care : using occlusive dressing or semiocclusive dressing, maintained for 2-3 weeks
     Recipient site care:
     Using moist, non-adhesive dressing, with well-distributed pressure
     Dressing change on day 3-4
     Caution should be taken during dressing changes to prevent rearrangement of the skin graft
    Technique
    FTSG
     Preparations : cleaning, debridement and hemostasis
     Harvesting and donor site care :
     Create an imprint from the recipient site
     Excision of donor site up to the subdermal junction according to the imprint design at the donor site
     Defatting  allowing better graft imbibition
     Donor site is closed primarily with sutures
     Insetting at the recipient site
     Graft fixation at the recipient site with sutures
     Fixation using tie-over dressing
     Hematoma or seroma beneath skin graft.
     Technical error; incomplete immobilization,
    Failure of Graft upside-down graft, skin graft rearranged
    Take  Inadequate vascularization of recipient site
    e.g. crush injury
     Infection
    Thank You 

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